Provider Demographics
NPI:1730501669
Name:ADAM R WINCKLER DDS PC
Entity Type:Organization
Organization Name:ADAM R WINCKLER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:WINCKLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-777-2237
Mailing Address - Street 1:1565 HAWKSLEY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-1782
Mailing Address - Country:US
Mailing Address - Phone:630-777-2237
Mailing Address - Fax:630-800-1541
Practice Address - Street 1:950 N YORK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2950
Practice Address - Country:US
Practice Address - Phone:630-655-8815
Practice Address - Fax:630-655-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027008122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty